Raloxifene

Raloxifene

(Evista)

Therapeutic Class:

Drug for osteoporosis prevention

Administration Alerts

Give with or without food. Pregnancy category X.

Black Box Warning

Raloxifene increases the risk of venous thromboembolism and death from strokes, especially in women with coronary artery disease or a prior history of thromboembolism.

Actions and Uses

Raloxifene is a SERM. It decreases bone resorption and increases bone mass and density by acting through the estrogen receptor. Raloxifene is primarily used for the prevention of osteoporosis in postmenopausal women. Although the drug reduces the occurrence of vertebral fractures caused by osteoporosis of the spine, it does not appear to reduce the incidence of fractures at nonvertebral sites. This drug also reduces total cholesterol and low-density lipoprotein (LDL) without lowering high-density lipoprotein (HDL) or triglycerides. Raloxifene is also approved to reduce the risk of breast cancer in postmenopausal women at high risk for invasive breast cancer. It is important for nurses and their patients to understand that this drug is for the prevention, not treatment, of breast carcinoma.

Pharmacologic Class:

Selective estrogen receptor modulator

Adverse Effects

The most common adverse effects of raloxifene therapy are hot flashes, leg cramps, and weight gain. Less common effects include fever, arthralgia, depression, insomnia, chest pain, peripheral edema, decreased cholesterol, nausea, vomiting, flatulence, cystitis, migraines, flulike symptoms, endometrial disorder, breast pain, and vaginal bleeding

Contraindications:

This drug is contraindicated during lactation and pregnancy and in women who may become pregnant. Patients with a history of venous thromboembolism and those who are hypersensitive to raloxifene should not take this drug.